Lawyer fights for towns paying toll in opioid epidemic

WEST DENNIS — A Cape-based litigator is taking on the pharmaceutical industry on behalf of cities and towns nationwide harmed by the opioid epidemic.

From the wraparound porch of rambling Victorian she shares with her husband and parents, Jayne Conroy, 59, explained how her firm has fought Big Pharma for years over fraudulent marketing practices.

Conroy has been involved in opioid-related lawsuits since 2002 when her firm, Simmons Hanly Conroy LLC, represented 5,000 patients across the country who allegedly became addicted to OxyContin as a result of false claims by Purdue Pharma and Abbott Laboratories Inc.

The case was settled in 2006 when the companies paid $75 million.

And in a landmark case in 2007, evidence uncovered by Conroy's team was used by the state of Virginia's Department of Criminal Justice Services to prove that the pharmaceutical companies had paid doctors and used false claims in marketing materials.

Purdue CEO Michael Friedman, medical director Paul Goldenheim and chief counsel Howard Udell all pleaded guilty to misleading the medical profession about the dangers of OxyContin. The companies paid $600 million in fees and settlements.

Now, Conroy and her firm are attacking the producers of OxyContin and other opioid-based drugs on a different front: They are suing four major drug companies on behalf of 12 cities, towns, parishes and counties nationwide that have had to pay the price — literally — for a drug epidemic.

This latest case started in 2016 with Suffolk County, New York. The plaintiffs now include nine counties in New York — Suffolk, Erie, Dutchess, Sullivan, Seneca, Schenectady, Oswego, Orange and Broome — as well as Kankakee County in Illinois, and Lafayette Parish and Avoyelles Parish in Louisiana.

More are expected to join in the next few weeks, Conroy said.

No Massachusetts city or town has signed on, but could at any time without financial risk, Conroy said. The suit is on a contingency basis, so the lawyers get paid only if they win, she said.

The lawsuit could be relevant for several Cape towns.

Julian Suso, Falmouth town manager, said the cost to his town has been steep.

“We all remain extraordinarily concerned about the impact of town services not just on police and fire but on the schools as well,” Suso said.

Last year, seven parents from one Falmouth elementary school died of drug overdoses, Charles Jodoin, the district’s director of student services, said earlier this year. Students are traumatized and exhibit reactive behavior requiring extra help in the classroom, he said.

Falmouth emergency calls for overdoses rose from 140 in 2015 to 165 in 2016, according to the Falmouth Fire Department. In 2015, overdose calls in Falmouth jumped 60 percent.

“We are vitally concerned, and very troubled by the impact on families as well as institutions in our town,” Suso said.

In a 2015 report, the Barnstable County Department of Human Services tallied the cost of opioid addiction on Cape Cod at $58 million a year.

These costs were mostly related to law enforcement — police, courts, jail and probation totaling $33.4 million and treatment and medical expenses, $23.6 million.

“It’s an enormous burden on communities,” Conroy said. “And that burden is what the pharmaceutical companies did.”

Conroy said it’s not hard to show how overtime costs, ambulance runs and overdose deaths have increased. Conroy's daughter works at Cape Cod Hospital and sees the overdose victims nightly, she said. Mike Lauf, chief executive officer of Cape Cod Healthcare, recently said an average of 20 people board overnight at the emergency room because of substance abuse.

She also said it’s not difficult to prove how Endo Pharmaceuticals, Purdue Pharma, Teva Pharmaceuticals and Janssen Pharmaceuticals fed cash to two major foundations — the American Pain Foundation and the American Academy of Pain Medicine — and four doctors in particular, who then touted the benefits of opioids for noncancer pain and downplayed the addictive properties.

These four doctors — Lynn Webster, Scott Fishman, Russell Portnoy and Perry Fine — are named as defendants in this suit.

The complaint states that company executives knew there was no science to support benefits of long-term use of opioids. There are no controlled studies of opioid use beyond 16 weeks, she said. Nonetheless, the pharmaceutical companies targeted the long-term chronic pain market for monetary gain, she said.

“They recognized that if they could cause their customers to become physically addicted to their drugs, they would increase the likelihood that their blockbuster profits would continue indefinitely,” the complaint states.

One of the most influential pieces of false marketing they uncovered was a five-sentence letter to the editor that appeared in the New England Journal of Medicine in 1980, Conroy said. The letter, written by two researchers, Jane Porter and Dr. Hershel Jick, referred to their study of hospitalized patients. The study found that out of nearly 12,000 treated with opioid painkillers, just four became addicted.

The letter, now referred to as “Porter and Jick,” has become a symbol of the runaway-train misinformation surrounding the opioid epidemic. Jick himself told the Associated Press he was “mortified” that the letter had been used to convince people the drugs are not addictive.

In fact, the study looked only at people given the drugs short term, while hospitalized, rather than sent home as a prescription.

“Purdue Pharma took that letter and used it like a peer-reviewed study,” Conroy said. “Doctors had no idea.”

A 2010 study published in the New England Journal of Medicine found the letter had been cited a total of 600 times, mostly inaccurately and without context.

It was even written up in a medical textbook, Conroy said.

Doctors are sitting ducks for misinformation by the pharmaceutical industry, she said. Her company does not usually sue doctors, because, she said, “We believe they were hoodwinked just like the consumers.”

“That’s just the way it is,” she continued. “A lot of information bombards the medical community and it’s hard to decide what is real and what is total fraud.”

The companies contacted by the Times emailed prepared statements.

“While we vigorously deny the allegations in the complaint, we share public officials’ concerns about the opioid crisis and we are committed to working collaboratively to find solutions,” stated Robert Josephson of Purdue Pharma.

Josephson sent a 61-page motion to dismiss the complaint. Purdue Pharma filed it with the Supreme Judicial Court in Suffolk County in June.

“At Endo, our top priorities include patient safety and ensuring that patients with chronic pain have access to safe and effective therapeutic options,” stated Heather Zoumas Lubeski, spokeswoman for Endo. ‘We share in the FDA’s goal of appropriately supporting the needs of patients with chronic pain while preventing misuse and diversion of opioid products.”

“We recognize opioid abuse is a serious public health issue that must be addressed,” stated Jessica Castles Smith, spokesperson for Janssen Pharmaceuticals Inc. “At the same time, we firmly believe the allegations in these lawsuits are both legally and factually unfounded. Janssen has acted responsibly and in the best interests of patients and physicians with regard to these medicines, which are FDA-approved and carry FDA-mandated warnings about possible risks on every product label.”

Two companies mentioned the Food and Drug Administration’s regulatory review as legitimizing the safety of their product. But Conroy said the FDA is at the core of the problem.

The FDA does not have well-funded researchers to fact-check the industry-funded drug trials, Conroy said.

“The FDA is totally reliant on drug companies' honesty when they present their product,” Conroy said.

The strategy employed by the pharmaceutical industry to create false advertising and bribing doctors to promote their product is not limited to opioids, added Conroy, who grew up in Woburn and has lived on the Cape on and off since the 1970s when her parents bought their home.

Last year, Conroy won a $1 billion jury verdict in Texas for six patients who suffered from faulty DePuy Pinnacle metal-on-metal hip replacement devices made by Johnson & Johnson. In that suit, Conroy aruged that the company misled doctors about the safety risks of the product and offered kickbacks to surgeons.

Last month, Attorney General Maura Healey announced her office has been working with a coalition of attorneys general from across the country in an ongoing investigation to evaluate drug makers who have engaged in unlawful practices in the marketing and sale of opioids. Her office would not comment on Conroy's suit.

The city of Chicago filed a lawsuit against five drug makers in 2014. Orange County and Santa Clara County in California issued a similar suit in May 2016.

These companies will fight “tooth and nail,” and will dedicate a team of defense attorneys to these lawsuits, Conroy said.

Conroy's company of over 150 lawyers plans to deploy 40 to 50 senior litigators, she said.

— Follow K.C. Myers @kcmyerscct.

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